Infection Prevention & Control Team. Your urinary catheter & how to care for it / Patient Information Leaflet

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1 Contact details Infection prevention team This leaflet can be made available in alternative languages/formats on request. Infection Prevention & Control Team / Your urinary catheter & how to care for it Patient Information Leaflet Creation date May 2015 Review date May 2018 Produced by the Infection Prevention & Control Team Whiston Hospital Warrington Road Prescot L35 5DR

2 What is a urinary catheter? A catheter can be made from plastic, latex or silicone rubber; it is a hollow, flexible tube designed to drain urine from the bladder. Once a catheter is in place, it is held in place by inflating a small balloon with sterile water. The balloon is at the end of the catheter inside your bladder, this stops it from slipping out. Who can insert a urinary catheter? Different professional groups are involved in inserting catheters in different settings. All staff involved in this procedure will have undertaken training, and been assessed as competent to do so. This type of catheter is usually designed to stay in place short term four weeks, and long term twelve weeks. It is referred to as an indwelling catheter. Why do I need a urinary catheter? Anyone who cannot empty his or her bladder may need to have a catheter. Your urine will continue to fill your bladder twenty four hours a day, every day. It is important to be able to empty your bladder regularly and completely. If you are unable to empty your bladder properly or pass urine in the normal way there is an increased risk of infection and backpressure that can potentially damage the kidneys. To prevent this, a catheter can be used to drain the urine from your bladder. A catheter should not limit your social or leisure activities, or stop you going away on holiday. In fact, some people find that it can be the start of improving their life. Where is the urinary catheter inserted? A catheter is inserted into the bladder through the urethra. This is a small opening above the vagina in women. In men the urethra runs through the length of the penis. In some people it may be necessary to insert into the bladder through the abdominal wall. This is called a supra pubic catheter (see page 4). What are the risks? People with a urinary catheter in place have an increased risk of: ANTT Urinary tract infection Stricture (narrowing of the urethra) Stone formation in the bladder Trauma to the urinary tract which may result in bleeding Pain and discomfort In this Trust all procedures that by-pass the body s natural barrier, such as a catheter entering into the bladder, are performed using Aseptic Non-Touch Technique. This is an internationally recognised approach to prevent infection during procedures and the on-going care of devices such as catheters.

3 What are the different types of urinary catheter? Intermittent Catheters (Short term use) This is when a catheter is placed in your bladder to allow urine to drain. When your bladder is empty it is then removed and thrown away. You would use a new catheter every time you needed to pass urine. Urethral Catheters (Indwelling catheter for longer term use) This type of catheter is inserted and left in your bladder to allow urine to drain continually. It can be attached to a valve which will allow you to drain your bladder when you need to by releasing the valve. A drainage bag can be attached to your leg which can be emptied when ¾ full, or it may be attached to a bigger bag which holds 2 litres and would be on a stand. This will depend on what you require to meet your individual needs. Supra Pubic Catheters (Indwelling catheter for longer term use) This type of catheter is inserted just above the bony area at the bottom of your abdomen. It goes into the bladder and drains in the same way as a urethral catheter would. This type of catheter would normally be placed in your bladder in hospital; you would also need to have the first change of your catheter done in hospital. Future changes of your catheter can be done in the Community. (This will be arranged by the community team looking after you). Patients or carers can be trained to change indwelling and intermittent catheters. What happens to the urine? Urine is produced by the kidneys and drains into the bladder through tubes called ureters. When the urine reaches the bladder it drains down the catheter and is collected into a leg bag. Alternatively, you will be shown how to use a catheter valve. A catheter valve has the advantage of maintaining the bladder s ability to store urine and may be considered more discreet. It may be useful to discuss this with your Nurse, as this is not a suitable option for everyone. How long will I need to have a catheter? You might need an indwelling catheter temporarily, after an operation, for example, or you may need to have one for a longer period. Please discuss this with your Nurse or Doctor. You should know why you have a catheter and when its use will be reviewed. The nursing staff will review the need for the catheter on a daily basis and when appropriate you will have the catheter removed. How often does the catheter need changing? Indwelling catheters need changing at regular intervals of between 4-12 weeks. The frequency of changes will depend on the material your catheter is made of and whether you experience problems with it blocking. Your Nurse will discuss with you when and your catheter will be changed. What problems may I experience? Initial discomfort Initially people with a catheter can experience bladder spasm or cramp and /or the desire to pass urine more often. These sensations usually subside within a few days. Those with neurological conditions or spinal injuries are more likely to experience this problem. If they persist it is advisable to speak to your Nurse or Doctor.

4 Infection or blood in the urine People with an indwelling catheter have an increased risk of urinary tract infection. Urinary tract infections can cause you to experience stinging or burning on passing urine, give you a temperature and make you feel generally unwell. It is helpful to be aware of the colour and odour of your urine. Should your urine become cloudy, contain blood, smell offensive or it becomes painful when you pass urine, speak to your Nurse or Doctor. Bypassing and blockage of the catheter Bypassing (urine draining out from around rather than through the catheter) may occur if your catheter or tubing becomes kinked. Adjust the catheter and check that your drainage system is flat against your leg and secured appropriately. The same measures can be taken when there is no drainage however, please seek advice if no urine drains after 2-3 hours. What can I do to reduce any problems? Personal Hygiene All people with a catheter should wash their genitals twice a day with soap and water and also after having their bowels open. Men should make sure they wash under their foreskin. Fluids Drinking 2 litres (4 pints) of mixed fluids a day may help flush the catheter and the catheter drain. Diet A diet rich in fresh fruit, vegetables and fibre is suggested, as this will help you to maintain a regular bowel pattern. It is recommended that you avoid becoming constipated as a full bowel can press on the catheter, preventing urine from draining freely. This is a common cause of leakage around the catheter. If you have problems and need help speak to your doctor, community team or ward staff. Changing and caring for drainage bags The drainage bag should be worn in a comfortable position against the thigh, knee or calf area (according to individual preference) and secured to your leg by straps or a sleeve/holder. It must be kept below the level of the bladder to drain. Do not kink/twist or clamp the catheter tubing and ensure that the bag is not in contact with the floor. In order to minimise the risk of infection it is essential to wash your hands with liquid soap and water before and after emptying, or changing your bag. When emptying the bag try to make sure that the outlet pipe and toilet, or other receptacle, do not come into contact. Bags need to be emptied when they are about three quarters full. The drainage bag should only be disconnected from the catheter when absolutely necessary to reduce the risk of introducing infection. The leg bag should only be changed every 5-7 days unless discoloured/dirty. Leg straps or sleeves help to secure the catheter and drainage bag in place and help reduce discomfort and damage to the bladder and urethra. There are a wide range of bags and straps/sleeves available. Catheter valves The catheter valve is attached directly to the end of the catheter enabling your bladder to continue storing urine. It is important for you to drain your bladder by opening the valve when you feel the need to pass urine, or every 3 hours. You should empty your bladder at least 3 hours during the day. At night time you need to have a night bag attached to the valve and the valve left open so that the urine can drain straight into the bag. This is called free drainage.

5 If you would like to find out more about these please ask your Nurse

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